27 Results for

Claims Analyst Jobs in Maryland

Jobs

Essex, MD23 days ago

$110,000–$140,000 Per Year
Full-time

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs. Seeking at least 5 years experience reviewing, investigating, and managing claims related to environmental, toxic tort, catastrophic injuries, construction defects, molestation or similar to advise on severe commercial general liability claims.

Baltimore, MD25 days ago

Full-time

This role will focus on onboarding vendors and brokers, managing enrollment processes, and supporting data exchanges related to ACA marketplace offerings, including ICHRA programs. Role: Claims Analyst (Enrollment & EDI) Location: Baltimore, MD (Remote) Type: Contract-to-Hire (C2H) Job Overview: We are seeking a detail-oriented Functional Analyst to support enrollment operations within a healthcare insurance environment.

Baltimore, MD30+ days ago

Remote

Full-time

Key Responsibilities Process medical claims accurately and efficiently in a high-volume environment Navigate the Facets G6 production platform to review and adjudicate claims Research, evaluate, and resolve claim discrepancies, edits, and errors Utilize internal tools such as SIR, TI Portal, and GuidingCare (if experienced) Maintain compliance with company policies and regulatory requirements Collaborate with supervisors and team members to meet quality and productivity goals Participate in a structured, instructor-led virtual training program Manage time effectively while working independently in a remote setting Required Skills & Experience Experience with: Stored Information Retrieval (SIR) Transaction Insight (TI Portal Database) HealthEdge GuidingCare Experience with HMO and PPO claims workflows Prior experience supporting Blue Cross Blue Shield plans ***Lumen and / or its clients will not provide equipment (Laptop, monitor, etc.) to the selected contractor. Role: Claims Processor Location: Remote Type: Contract Position Summary We are seeking experienced Claims Processors to join our remote team supporting the HMO and PPO lines of business.

Frederick, MD30+ days ago

$41–$50 Per Hour
Contractor

Define and document interface requirements between systems Key Requirements and Technology Experience: Key Skills; Strong skills in requirements HL7, FHIR, EDI 835 CMS Interoperability Bachelor’s degree in a relevant discipline 4 years of experience in business analysis or data integration roles within healthcare, payer, or health IT Hands-on experience in supporting data exchange / integration workflows, claims processing, and remittance logic Proficiency in data validation, profiling, and transformation Strong skills in requirements HL7, FHIR, EDI 835 Ability to communicate complex ideas in business-friendly language Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners.

New!

Bethesda, MD2 days ago

Remote

Full-time

Professional CertificationsNone requiredYears of Professional Experience10 years of professional (an additional 10 years of experience may be substituted for education)Desired experienceExperience working in an Agile environment. Citizenship required for this specific opportunitySecurity Clearance RequirementsMust possess or qualify for a Public Trust (MBI)CRITICAL NOTES: SSG will not make assumptions regarding your qualifications.

Baltimore, MD30+ days ago

Remote

Full-time

Collaborate with multiple business partners including but not limited to Contracting Administration, Corporate Compliance, Claims Administration, and Legal to create strategies for contract templates while being proactive in preventing non-compliance. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Baltimore, MD30+ days ago

Remote

Full-time

Technical Skills: Knowledge of the healthcare industry; expertise with data modeling & data mining; experience with data architecture, design & development, with DB2 and MS SQL DBMS, one or more OLAP/Reporting tools (Cognos and Microsoft Analysis Services, ETL tools (Cognos Data Manager or MS SQL EIS); experience with Tableau; strong knowledge of Excel, Access, and query language/software. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Silver Spring, Maryland30+ days ago

$30–$34 Per Hour

This position will play a key role in managing complex accounts, ensuring accurate reimbursement, and supporting overall revenue cycle performance for dialysis services. A leading healthcare organization is expanding its internal dialysis services and is seeking a Program Coordinator to support billing and collections operations.

Bethesda, MD30+ days ago

$55,000–$70,000 Per Year

Assistant Resolutions Analyst typically requires 2+ years of relevant experience, a Paralegal Certification, associate degree or preferably bachelor's degree. Associate Resolutions Analyst typically requires 4+ years of relevant experience, a Paralegal Certification, associate degree or preferably bachelor's degree.

New!

Columbia, Maryland3 days ago

Our client is seeking a Senior Data Analyst to support enterprise analytics initiatives focused on Medicare Advantage Stars and Risk Adjustment programs within a healthcare payor environment. This role will partner closely with business leaders, policy teams, and technology stakeholders to drive provider data accuracy, reporting, and strategic decision-making.

New!

Dentsville, SC1 day ago

This role will serve as a key testing and quality assurance resource responsible for validating system functionality, developing test strategies, supporting automation testing, and ensuring software quality across multiple applications and integrations. We are seeking an experienced Quality Assurance Analyst – Advanced to support enterprise enrollment, eligibility, claims processing, and document management systems within a large healthcare technology environment.

Maryland, MD17 days ago

Remote

Senior Business Analyst to support the development and enhancement of various AI/ML products for partner Blues plans to help process claims. The current environment is on Agile Scrum, and the team is using technologies such as Snowflake, AWS Bedrock, and Amazon SageMaker.

Hanover, MD30+ days ago

Communicates appeal determinations in accordance with regulatory requirements and serves as a clinical resource to support non-clinical staff with administrative denials and coding-related appeals. Prior experience within a health insurance or payer environment strongly preferred, including case management, utilization management, appeals, or claims processing.

Aberdeen Proving Ground, MD30 days ago

Founded in 2006, we specialize in cybersecurity, information assurance, systems engineering, enterprise IT and network support, C4ISR, and software development, with internal R&D in extended reality (XR)—including VR, AR, and MR—for training and simulation. Envision Innovative Solutions is a trusted technology and engineering partner delivering mission critical capabilities to government and commercial clients.

New!

Columbia, MD3 days ago

Glint Tech Solutions is looking for a skilled Data Analyst with Healthcare Payor experience to support a Provider Data Transformation project involving Salesforce migration and healthcare data integrations. Develop data-driven insights and technical solutions to improve data accessibility.

Lexington Park, MD8 days ago

Powered by our highly skilled workforces, we provide expert consultation on network and weapons systems acquisition programs, maintenance/modernization programs, and sustainment programs with solutions in Digital Transformation, Advanced Engineering, Physical Sciences Research, Platform Lifecycle Support, and Technical Services. reads regulations and directives and assists in preparing necessary briefing material related to such regulations and directives; prepares reports and summaries; or assists with replies to inquiries; selecting relevant information from a variety of sources such as reports, documents, correspondence, and other offices.

Annapolis, Maryland30 days ago

Baker Tilly Advisory Group, LP and Baker Tilly US, LLP, trading as Baker Tilly, are independent members of Baker Tilly International, a worldwide network of independent accounting and business advisory firms in 141 territories, with 43,000 professionals and a combined worldwide revenue of $5.2 billion. Baker Tilly is a leading advisory, tax and assurance firm, providing clients with a genuine coast-to-coast and global advantage in major regions of the U.S. and in many of the world's leading financial centers - New York, London, San Francisco, Los Angeles, Chicago and Boston.

Columbia, MD9 days ago

Full-time

The ideal candidate will partner closely with leadership, business teams, and engineering groups to ensure provider data accuracy, optimize reporting processes, and support critical business decisions through data-driven insights. The Data Analyst will be responsible for analyzing complex datasets, developing ETL solutions, creating dashboards and reports, and improving overall data quality and accessibility across enterprise systems.

Annapolis, MD30+ days ago

Working knowledge of various databases utilized in accomplishing the research required to understand, track/monitor and improve submarine maintenance including Navy Enterprise Resource Planning (N-ERP), Product Data Reporting and Evaluation Program (PDREP), eCANNAB, the In-Service Submarine and Sustainment Reliability Portal (ISARP), the Naval Sea Logistics Center (NSLC) suite of tools, Maintenance and Ship Work Planning (M&SWP), and Submarine Maintenance Monitoring Information Systems (SMMIS) is preferred. The Team Submarine concept unifies once diverse submarine-related activities into a single submarine-centric organization with the goal of eliminating traditional stovepipe structures and processes that created impediments and inefficiencies in the submarine research, development, acquisition, and maintenance communities.

Baltimore, MD30+ days ago

Remote

Full-time

Analyzes data by combining multiple data sources and researching various system and healthcare issues in order to perform on time research and analysis to formulate solutions for issues of low to moderate scope and complexity. • Works with management to understand and interpret the impact of decisions made by retrieving, analyzing and identifying variations and trends in healthcare data, and communicating the information obtained from analysis.

Columbia, MD9 days ago

$72.23–$77.23 Per Hour

Responsibilities:The Data Analysis Consultant leads the creation of cutting-edge analytic tools to drive better and faster decision making within the organization and provides critical support for key corporate programs, Medicare Advantage Stars and Risk Adjustment programs as it relates to provider data, provider to claims process. 50% Supports enterprise Stars and Risk adjustment strategy through collaboration with analysts, healthcare policy makers, and strategy leaders throughout the company to identify trends and opportunities across the Medicare and Medicaid healthcare landscape.

New!

Frederick, MD2 days ago

Remote

Full-time

Implement the evolution from a Microsoft SQL eXtensible Markup Language (MSSQL XML) object store toward a scalable, cloud-native AWS data architecture that enables business stakeholders and analysts to run performant, SQL-based reports and queries against healthcare data seamlessly. Evaluate and recommend the optimal AWS-native data storage and query architecture for the XML object store data, assessing options such as S3 + Athena, Aurora, DynamoDB, Redshift, and OpenSearch based on query patterns, reporting needs, cost, and scalability.

Bethesda, MD30+ days ago

Full-time

We are seeking a Marketing Lead, Precision Care AI Solutions, who will operate as an AI-native growth leader—using modern AI tools, agentic workflows, and creative experimentation to drive significant, measurable sales pipeline and establish GW RhythmX as the undisputed thought leader in Precision Care AI. A SymphonyAI Group company, GW RhythmX leverages various firm assets, including $1B+ in R&D investment, longitudinal data related to 300 million patients, 4.4 billion total annual claims, and 1.8 million healthcare professionals at more than 3,000 facilities globally.

Baltimore, MD30+ days ago

Full-time

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.

Baltimore, MD30+ days ago

Remote

Full-time

Oversee architecture changes for all data ingestion solutions and provide technical advice on complex data mappings and transformations, including production support guidance, researching, and responding to security vulnerability findings, and working with multiple vendors and teams to leverage existing architecture components. - Facilitate the creation of architectures that consider how the current system interacts with other internal and external systems and environments and ensure that the new system behaves and performs correctly, including: prioritizing backlog projects and coordinating with system and network administration personnel on maintenance, upgrades, changes, and performance needs.

New!

Annapolis, MD6 days ago

Expert knowledge of Highmark's financial and operational systems including but not limited to billing, revenue estimation, claims, supporting source systems, and general ledger including how these systems interact with each other during day to day operations and monthly reporting processes. Expert knowledge of product structures to ensure product results are reflected appropriately in the general ledger and other data repositories to facilitate financial analysis and forecasting processes.

Silver Spring, Maryland30 days ago

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Claims Analyst Jobs in Maryland

Insurance Claims Environmental Diedre Moire Corp.

Claims Analyst (Enrollment & EDI) Lumen Solutions Group Inc

Claims Processor Lumen Solutions Group Inc

Business Analyst (CMS Interoperability HL7, EDI) Pyramid, Inc

Senior Business Process Analyst Syms Strategic Group, LLC (SSG)

Contract QC Analyst TriWest Healthcare Alliance

Business Intelligence Analyst TriWest Healthcare Alliance

Billing & Collections Analyst Addison Group

Assistant or Associate Resolutions Analyst or Counsel United Educators

Sr. Data Analyst Glint Tech Solutions LLC

Quality Assurance Analyst – Advanced - 26-06248 NavitasPartners

Senior Business Analyst Abidi Group LLC

Appeals Nurse (RN) Analyst Johns Hopkins Medicine

Logistics Analyst Envision Innovative Solutions

Data Analyst Glint Tech Solutions LLC

Operations Analyst Precise Systems

Temporary Application Analyst Baker Tilly Advisory Group, LP

Data Analyst (Healthcare) Lumen Solutions Group Inc

Senior Logistics Analyst (Submarines) - Washington DC Serco

Data Analyst TriWest Healthcare Alliance

Data Analysis Consultant Iconma

Senior Systems Engineer (AWS Data Engineer) Syms Strategic Group, LLC (SSG)

Marketing Lead, Precision Care AI Solutions GetWellNetwork, Inc.

Reporting Specialist Maximus

Data Architect Maximus

Manager Operational Accounting Highmark Health

Credentialing Specialist Little Leaves

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